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901 to 925 of 1,007Dissociation in How Core Autism Features Relate to Interoceptive Dimensions: Evidence from Cardiac Awareness in Children.
Interoception in autism is receiving increasing research attention. Previously, differences were identified in autism on both objective and subjective measures of interoception, and an association with anxiety. Yet, it is currently unknown how interoception relates to core autism features. Here, in 49 autistic children, we consider how interoceptive accuracy (measured with heartbeat detection tasks) and sensibility (subjective judgements of awareness) relate to overall severity on the Autism Diagnostic Observation Schedule, and symptom domains of social-affective and repetitive, restricted behaviors. Socio-affective features were related to interoceptive sensibility, while repetitive restricted behaviors were related to interoceptive accuracy. This dissociation suggests disparate interoceptive mechanisms for the formation and/or maintenance of autistic features.
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Relationship between interoception and emotion regulation: New evidence from mixed methods.
Background: Interoception is the ability to perceive one's inner bodily feelings and is thought to be associated with the capacity of recognising and experiencing emotions. Previous research on interoception and emotion regulation has presented limitations arising from the low reliability of the interoceptive measurement and provided inconsistent results. The current study used a mixed method approach to investigate this relationship from the individuals' perspective.
Methods: In the first phase (quantitative), questionnaires assessing interoceptive sensibility, the subjective, self-reported ability to perceive internal states, were administered to 100 healthy participants. In the second phase (qualitative), individual semi-structured interviews were conducted with nine participants. The interviews were analysed using the Interpretative Phenomenological Analysis. Three main dimensions we…
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Dimensions of Body-Awareness and Depressed Mood and Anxiety.
Interoception, the multidimensional ability to sense the physiological condition of the body, is a key mechanism in emotional processing. However, the relationships between interoceptive dimensions and depressed mood and anxiety have not been widely studied. The aim of this secondary analysis, correlational and cross-sectional study, was to determine the relationships among interoceptive accuracy, interoceptive sensibility, depressed mood, and anxiety in adults with hypertension. The sample consisted of 76 adults, predominately African American women. Correlational analysis showed that most participants had low levels of interoceptive accuracy and relatively high levels of interoceptive sensibility. Interoceptive sensibility was negatively associated with depressed mood and anxiety. Interoceptive accuracy and interoceptive sensibility were not associated between each other. Further exami…
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Interoceptive deficits in patients with obsessive-compulsive disorder in the time course of cognitive-behavioral therapy.
Interoception is impaired in different psychiatric disorders and is also associated with emotions. Only one study could show a higher interoceptive accuracy (IAcc) in patients with obsessive-compulsive disorder (OCD). Based on the predictive coding system we assume contrary results, indicating a decreased IAcc in patients with OCD. So far, there is no study investigating the effect of cognitive-behavioral therapy on IAcc in patients with OCD. Therefore, we hypothesize that patients with OCD improve their IAcc during the time course of therapy compared to healthy controls. Twenty-six patients with OCD from the Psychosomatic Clinic in Windach were examined in the time course of cognitive-behavioral therapy. They were compared to 26 matched healthy controls. IAcc via the heartbeat perception task as well as questionnaire data (OCD-, depression- and anxiety symptoms) were assessed. Results s…
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Acute cortisol response to a psychosocial stressor is associated with heartbeat perception.
The aim of the present study was to examine the effect of an acute increase in cortisol in response to a psychosocial stressor on heartbeat perception, in a laboratory environment. Thirty-six participants (20 women, 16 men, mean age = 21.7 years, standard deviation = 1.7 years) completed a heartbeat counting task (Schandry paradigm) before and after exposure to an acute psychosocial stressor (Trier Social Stress Test; TSST). Heartbeat counting performance was compared between participants who exhibited strong cortisol responses (>15.5% increase in cortisol from baseline; responders) and those who did not (non-responders). Responders showed increased heartbeat counting accuracy following the TSST, which was not observed in non-responders. The two groups did not differ in their responsivity to subjective anxiety ratings or heart rate. These results indicated that acutely elevated cortisol …
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Affective interoceptive inference: Evidence from heart-beat evoked brain potentials.
The perception of internal bodily signals (interoception) is central to many theories of emotion and embodied cognition. According to recent theoretical views, the sensory processing of visceral signals such as one's own heartbeat is determined by top-down predictions about the expected interoceptive state of the body (interoceptive inference). In this EEG study we examined neural responses to heartbeats following expected and unexpected emotional stimuli. We used a modified stimulus repetition task in which pairs of facial expressions were presented with repeating or alternating emotional content, and we manipulated the emotional valence and the likelihood of stimulus repetition. We found that affective predictions of external socially relevant information modulated the heartbeat-evoked potential, a marker of cardiac interoception. Crucially, the HEP changes highly relied on the expecte…
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Interoceptive accuracy scores from the heartbeat counting task are problematic: Evidence from simple bivariate correlations.
Interoception, the capacity to perceive internal bodily states, is thought to influence cognitive, affective and interpersonal functioning. It is frequently assessed using the heartbeat counting task, introduced recently in interoceptive research. In this task participants are requested to count their heartbeats without relying on external cues. Interoceptive Accuracy (i.e., IAcc) scores are then computed based on absolute comparisons between actual and reported heartbeats. In a large sample of participants (N = 572), we observed that, whereas IAcc scores are meant to be theoretically agnostic to error type (i.e., over- or underestimation of heartbeats), these scores massively (i.e., > 95%) reflect under-reports. Of concern too, the correlation between actual and reported heartbeats is low overall (r = .16), varies non-linearly across IAcc score quantiles, and suggests undistinguishable …
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The role of mid-insula in the relationship between cardiac interoceptive attention and anxiety: evidence from an fMRI study.
Interoception refers to the perception of the internal bodily states. Recent accounts highlight the role of the insula in both interoception and the subjective experience of anxiety. The current study aimed to delve deeper into the neural correlates of cardiac interoception; more specifically, the relationship between interoception-related insular activity, interoceptive accuracy, and anxiety. This was done using functional magnetic resonance imaging (fMRI) in an experimental design in which 40 healthy volunteers focused on their heartbeat and anxious events. Interoceptive accuracy and anxiety levels were measured using the Heartbeat Perception Task and State Trait Anxiety Inventory, respectively. The results showed posterior, mid and anterior insular activity during cardiac interoception, whereas anxiety-related activation showed only anterior insular activity. Activation of the anterio…
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Prenatal androgen exposure causes hypertension and gut microbiota dysbiosis.
Background: Conditions of excess androgen in women, such as polycystic ovary syndrome (PCOS), often exhibit intergenerational transmission. One way in which the risk for PCOS may be increased in daughters of affected women is through exposure to elevated androgens in utero. Hyperandrogenemic conditions have serious health consequences, including increased risk for hypertension and cardiovascular disease. Recently, gut dysbiosis has been found to induce hypertension in rats, such that blood pressure can be normalized through fecal microbial transplant. Therefore, we hypothesized that the hypertension seen in PCOS has early origins in gut dysbiosis caused by in utero exposure to excess androgen. We investigated this hypothesis with a model of prenatal androgen (PNA) exposure and maternal hyperandrogenemia by single-injection of testosterone cypionate or sesame oil vehicle (VEH) to pregnant…
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Is alexithymia characterised by impaired interoception? Further evidence, the importance of control variables, and the problems with the Heartbeat Counting Task.
Interoception, the perception of one's internal state, is commonly quantified using the heartbeat counting task (HCT) - which is thought to be a measure of cardiac interoceptive sensitivity (accuracy). Interoceptive sensitivity has been associated with a number of clinical traits and aspects of higher order cognition, including emotion processing and decision-making. It has been proposed that alexithymia (difficulties identifying and describing one's own emotions) is associated with impaired interoceptive sensitivity, but new research questions this association. Problematically, much evidence attesting to the absence of this association has been conducted using the HCT, a measure affected by various physiological and psychological factors. Here, we present novel data (N = 287) examining the relationship between alexithymia and HCT performance, controlling for a number of potential confou…
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The link between interoceptive processing and anxiety in children diagnosed with autism spectrum disorder: Extending adult findings into a developmental sample.
Anxiety is a major associated feature of autism spectrum disorders. The incidence of anxiety symptoms in this population has been associated with altered interoceptive processing. Here, we investigated whether recent findings of impaired interoceptive accuracy (quantified using heartbeat detection tasks) and exaggerated interoceptive sensibility (subjective sensitivity to internal sensations on self-report questionnaires) in autistic adults, can be extended into a school-age sample of children and adolescents (n = 75). Half the sample had a verified diagnosis of an Autism Spectrum Disorder (ASD) and half were IQ- and age-matched children and adolescents without ASD. The discrepancy between an individual's score on these two facets of interoception (interoceptive accuracy and interoceptive sensibility), conceptualized as an interoceptive trait prediction error, was previously found to pre…
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Interoceptive influences on peripersonal space boundary.
Integration of body-related signals within the peripersonal space (PPS) contributes to bodily self-awareness. Whereas several studies have shown how individual PPS extension is shaped by external factors, e.g. during interactions with people and objects, no studies have looked at interoceptive influences on PPS extension. We exposed participants to an audio-tactile interaction task, to measure their PPS boundary (Session 1), and to a heartbeat counting task and a time estimation task, to specifically assess their interoceptive accuracy (Session 2). Participants' traits of private self-consciousness and social anxiety were also evaluated, to account for their possible effect on the relation between interoception and PPS representation. We found that higher interoceptive accuracy specifically predicts narrower PPS boundary. Moreover, this relation is moderated by individual traits of priva…
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Knowledge of resting heart rate mediates the relationship between intelligence and the heartbeat counting task.
Evidence suggests that intelligence is positively associated with performance on the heartbeat counting task (HCT). The HCT is often employed as measure of interoception - the ability to perceive the internal state of one's body - however it's use remains controversial as performance on the HCT is strongly influenced by knowledge of resting heart rate. This raises the possibility that heart rate knowledge may mediate the previously-observed association between intelligence and HCT performance. Study One demonstrates an association between intelligence and HCT performance (N = 94), and Study Two demonstrates that this relationship is mediated by knowledge of the average resting heart rate (N = 134). These data underscore the need to account for the influence of prior knowledge and beliefs when examining individual differences in cardiac interoceptive accuracy using the HCT.
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The heartbeat counting task largely involves non-interoceptive processes: Evidence from both the original and an adapted counting task.
The heartbeat counting task (HCT) is among the most frequently used measures of interoceptive accuracy (i.e., IAcc). Growing concerns, however, have been raised regarding the validity of this task, as well as the validity of the IAcc scores that are derived from it. In the present study, healthy participants (N = 123) performed both the original task and an adapted version of it that stressed the importance of reporting only their perceptually felt heartbeats. In the original task, we found that participants report relying on three different strategies (i.e., detection of heartbeats in a specific body location, detection of heartbeats in a diffuse way and heart rate estimation) to complete the task. In the adapted task, we found that IAcc scores are drastically reduced (about 50%) when asking participants to avoid relying on non-interoceptive signals and to only report the heartbeats the…
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Stress-related dysfunction of the right inferior frontal cortex in high ruminators: An fNIRS study.
Repetitive thinking styles such as rumination are considered to be a key factor in the development and maintenance of mental disorders. Different situational triggers (e.g., social stressors) have been shown to elicit rumination in subjects exhibiting such habitual thinking styles. At the same time, the process of rumination influences the adaption to stressful situations. The study at hand aims to investigate the effect of trait rumination on neuronal activation patterns during the Trier Social Stress Test (TSST) as well as the physiological and affective adaptation to this high-stress situation.
Methods: A sample of 23 high and 22 low ruminators underwent the TSST and two control conditions while their cortical hemodynamic reactions were measured with functional near-infrared spectroscopy (fNIRS). Additional behavioral, physiological and endocrinological measures of the stress response…
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Sensitivity to CT-optimal, Affective Touch Depends on Adult Attachment Style.
Affective touch supports affiliative bonds and social cognition. In particular, gentle, stroking touch, which has recently been associated with the C Tactile (CT) system, is typically perceived as pleasant and prosocial. However, it remains unknown whether pre-existing models of social relating influence the perception of CT-optimal touch. In this study (N = 44 adults), we examined how individual differences in attachment styles relate to the perception of CT-optimal touch, as well as to a different modality of interoception, namely heartbeat perception. Using the gold-standard assessment of attachment (Adult Attachment Interview), we found that insecure attachment was associated with reduced pleasantness discrimination between CT-optimal vs. non-CT optimal touch. Acknowledging the different traditions in measuring attachment, we also used a well-validated self-report questionnaire that …
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Salamone PC, Esteves S, Sinay VJ, García-Cordero I, Abrevaya S, Couto B, Adolfi F, Martorell M, Petroni A, Yoris A, Torquati K, Alifano F, Legaz A, Cassará FP, Bruno D, Kemp AH, Herrera E, García AM, Ibáñez A, Sedeño L (2018)MEDLINE-indexed journal, not yet read by usHuman brain mapping60 citations Altered neural signatures of interoception in multiple sclerosis.
Multiple sclerosis (MS) patients present several alterations related to sensing of bodily signals. However, no specific neurocognitive impairment has yet been proposed as a core deficit underlying such symptoms. We aimed to determine whether MS patients present changes in interoception-that is, the monitoring of autonomic bodily information-a process that might be related to various bodily dysfunctions. We performed two studies in 34 relapsing-remitting, early-stage MS patients and 46 controls matched for gender, age, and education. In Study 1, we evaluated the heartbeat-evoked potential (HEP), a cortical signature of interoception, via a 128-channel EEG system during a heartbeat detection task including an exteroceptive and an interoceptive condition. Then, we obtained whole-brain MRI recordings. In Study 2, participants underwent fMRI recordings during two resting-state conditions: min…
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Utilization of machine learning for prediction of post-traumatic stress: a re-examination of cortisol in the prediction and pathways to non-remitting PTSD.
To date, studies of biological risk factors have revealed inconsistent relationships with subsequent post-traumatic stress disorder (PTSD). The inconsistent signal may reflect the use of data analytic tools that are ill equipped for modeling the complex interactions between biological and environmental factors that underlay post-traumatic psychopathology. Further, using symptom-based diagnostic status as the group outcome overlooks the inherent heterogeneity of PTSD, potentially contributing to failures to replicate. To examine the potential yield of novel analytic tools, we reanalyzed data from a large longitudinal study of individuals identified following trauma in the general emergency room (ER) that failed to find a linear association between cortisol response to traumatic events and subsequent PTSD. First, latent growth mixture modeling empirically identified trajectories of post-tr…
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Interoception and gender: What aspects should we pay attention to?
Interoception is involved in both somatic and mental disorders with different prevalence between genders; however, gender differences are often neglected. To examine the potential gender differences in interoceptive awareness, we recruited 376 healthy subjects (51% males, aged 17-30years), to fill in the Multidimensional Assessment of Interoceptive Awareness (MAIA). Of that sample, in a subgroup of 40 subjects (50% males), interoceptive accuracy was assessed by heartbeat counting task (HCT). The results on interroceptive awareness suggest that females tendto notice bodily sensations more often, better understand relations between bodily sensations and emotional states, worry or experience more emotional distress with sensations of pain or discomfort and see body as less safe. The results of interoceptive accuracy further suggest that females are less efficient in consciously detecting he…
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Yoris A, García AM, Traiber L, Santamaría-García H, Martorell M, Alifano F, Kichic R, Moser JS, Cetkovich M, Manes F, Ibáñez A, Sedeño L (2017)MEDLINE-indexed journal, not yet read by usPsychological medicine70 citations The inner world of overactive monitoring: neural markers of interoception in obsessive-compulsive disorder.
Background: Obsessive-compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients' relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition.
Method: We administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of …
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Sleep and the heart: Interoceptive differences linked to poor experiential sleep quality in anxiety and depression.
Interoception is the sense through which internal bodily changes are signalled and perceived. Individual differences in interoception are linked to emotional style and vulnerability to affective disorders. Here we test how experiential sleep quality relates to dimensions of interoceptive ability. 180 adults (42 'non-clinical' individuals, 138 patients accessing mental health services) rated their quality of sleep before performing tests of cardiac interoception. Poor sleep quality was associated with lower measures of interoceptive performance accuracy, and higher self-report measures of interoceptive sensibility in individuals with diagnoses of depression and/or anxiety. Additionally, poor sleep quality was associated with impaired metacognitive interoceptive awareness in patients with diagnoses of depression (alone or with anxiety). Thus, poor sleep quality, a common early expression o…
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Bilateral Rolandic operculum processing underlying heartbeat awareness reflects changes in bodily self-consciousness.
Exteroceptive bodily signals (including tactile, proprioceptive and visual signals) are important information contributing to self-consciousness. Moreover, prominent theories proposed that visceral signals about internal bodily states are equally or even more important for self-consciousness. Neuroimaging studies have described several brain regions which process signals related to bodily self-consciousness (BSC) based on the integration of exteroceptive signals (e.g. premotor cortex, angular gyrus, supramarginal gyrus and extrastriate body area), and that another brain region, the insula/operculum which is involved in interoception and interoceptive awareness, processes signals critical for self-awareness. Providing evidence for the integration of exteroceptive and interoceptive bodily signals, recent behavioral experiments have demonstrated that the manipulation of interoceptive (e.g. …
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How Human Amygdala and Bed Nucleus of the Stria Terminalis May Drive Distinct Defensive Responses.
The ability to adaptively regulate responses to the proximity of potential danger is critical to survival and imbalance in this system may contribute to psychopathology. The bed nucleus of the stria terminalis (BNST) is implicated in defensive responding during uncertain threat anticipation whereas the amygdala may drive responding upon more acute danger. This functional dissociation between the BNST and amygdala is however controversial, and human evidence scarce. Here we used data from two independent functional magnetic resonance imaging studies [n = 108 males and n = 70 (45 females)] to probe how coordination between the BNST and amygdala may regulate responses during shock anticipation and actual shock confrontation. In a subset of participants from Sample 2 (n = 48) we demonstrate that anticipation and confrontation evoke bradycardic and tachycardic responses, respectively. Further…
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Interoception in pathological health anxiety.
According to cognitive-behavioral models, pathological health anxiety is triggered and maintained by the perception of mostly mild and benign bodily sensations that are misinterpreted as signs of illness. Arguably, abnormalities in interoception may account for this misguided preoccupation with somatic sensations. Using a multimethod approach, the current study investigated possible abnormalities in interoception in patients with pathological health anxiety (PHA; n = 51) and healthy participants (n = 56). Different types of interoception were assessed with a heartbeat-tracking task and a signal-detection task for nonspecific skin conductance fluctuations (NSCFs task). Patients compared with healthy participants showed a more liberal interoceptive response bias for NSCFs, t(79) = 2.32, p = .02, d = 0.53, 95% confidence interval (CI) (0.30, 0.68). Specifically, patients with a comorbid anx…
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Normal interoceptive accuracy in women with bulimia nervosa.
Previous studies suggest that patients suffering from bulimia nervosa (BN) have difficulties in perceiving internal bodily signals, mostly assessed by self-report questionnaires. Whether interoception is, in this case, attenuated or not remains an open question. Therefore, interoceptive processes were examined in twenty-three patients with current BN and were compared to healthy participants. We investigated Interoceptive Accuracy (IAc) assessed by the heartbeat detection task and Interoceptive Awareness (IA) assessed by the Eating Disorder Inventory-2. Patients with BN and healthy participants did not differ in terms of IAc when controlling for BMI, depression and anxiety, whereas IA among BN patients was found to have decreased. Although IAc and IA were not related among controls, we observed an inverse correlation in BN, suggesting that an abnormal overlap between these two levels of …
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